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More about magnesium.


In 490 B.C., a Greek army routeda larger force of Persian invaders in a fierce battle across the Marathon Plain. Legend has it that after the battle a Greek soldier named Pheidippides ran the 26 miles from Marathon to Athens with news of the victory, delivered his message, collapsed, and died.

Pheidippides is remembered to dayas the the first marathon runner. He may also hold a more dubious distinction: his death may be the first recorded case of a heart attack brought on by an acute loss of magnesium from overexertion in the hot sun. Today, when a well-conditioned athlete dies suddenly while competing, some doctors immediately suspect a magnesium deficiency. More and more research is showing that low levels of magnesium in the body can contribute to many cardiovascular diseases, including arrhythmias, sudden heartbeat disturbances that can lead to cardiac arrest.

Researchers have known for manyyears that the magnesium in the typical American diet is barely adequate for young women and not nearly adequate for men. Our bodies need about 3 milligrams of magnesium per day for every pound of body weight. Most of us get less than 2 milligrams per pound, however, and this deficiency could be responsible for many of our health problems.

To Mildred Seelig, M.D., theeditor of the Journal of the American College of Nutrition and the adjunct professor of preventive and community medicine at New York Medical College in Valhalla, New York, the most exciting area of magnesium research is the relation of the mineral to cardiovascular diseases. "Increasing evidence suggests magnesium may well be protective against certain types of heart disease," she said. And if anyone would know what magnesium can and can't do, Dr. Mildred Seelig would: most researchers in the field agree she is one of the world's leading authorities on magnesium. For more than 20 years she has been at the forefront of magnesium research and education. Besides writing a definitive text on the mineral. Magnesium Deficiency in the Pathogenesis of Disease. Dr. Seelig lectures in symposiums around the world to alert the medical profession to the importance of magnesium. We asked Dr. Seelig to tell us more about magnesium, our hearts, and our health.

Magnesium and Heart Disease

Post: ARe we more likely to haveheart attacks if we aren't getting enough magnesium?

Dr. Seelig: Perhaps. Countrieswhere magnesium is supplied in much larger quantities, such as in the Orient and India, have a much lower heart-disease death rate than Western countries. Probably the highest death rate from heart disease in young men is in Finland, which has been called "the country of young widows." There the magnesium level is the lowest. The United States comes a pretty close second to Finland in incidence of heart disease.

Post: Does the difference in magnesiumintake come only from diets? Could magnesium in hard water keep hearts healthier?

Dr. Seelig: Back in the '40s, researchersfound that the death rate for heart disease, sudden heart attacks, and strokes was very much higher in areas where the water was soft than where it was hard. In England, researchers originally believed calcium was the protective mineral in the water, because calcium from the limestone underlying England was responsible for most of the hardness in the water. But Dr. T. Crawford showed there was less magnesium in the hearts of accident victims--and more scarring, suggestive of small heart attacks--in soft-water areas of Glasgow than in hard-water areas of London.

In 1971, Drs. Terry Anderson andW.H. LeRiche did a very careful study in Ontario and found that what they called electrical death--sudden arrhythmias--occurs far more frequently in the areas where the water is soft than where it is hard. Examination of the hearts of the people who died of sudden heart attacks showed that only magnesium, of several minerals studied in the hearts of accident victims, consistently correlated with the heart-attack rate. Those who died in the soft-water areas had lower magnesium content in their hearts than those who died in the hard-water areas.

Post: Are there hard-water areas inthe United States where people don't have as much heart disease?

Dr. Seelig: Parts of the northernand central Great Plains have a high magnesium content in the soil and water. In the late '50s, Dr. Phillip Enterline and his associates went up to North Dakota to find out why some people there lived so long even though they had all the classic dietary errors of the United States. They had high fat, high salt, high calcium, heavy smoking, heavy drinking--and yet these people lived as long as 80, 90, and sometimes older. The researchers wanted to know what it was in North Dakota that was responsible for this extraordinary life expectancy despite the very bad dietary habits. They found they had to interview the young people out in the fields because the old people at home could speak only Finnish. This was a beautiful case--the people from Finland, where the death rate is the highest in the world for young men, had come to North Dakota and had lived into their 90s.

The only point the researchersfound that was significantly different between Finland and North Dakota was that the water they drank in North Dakota contained a great deal of magnesium.

Conversely, in some parts of theSoutheast and Northeast, the magnesium level is very low and the heart-attack rate is very high.

Post: Research h as shown that low-densitylipoprotein cholesterol contributes to heart disease and that high-density lipoprotein cholesterol may actually protect against heart disease. How does magnesium fit into this picture?

Dr. Seelig: Enzyme systems dependenton magnesium influence how the body handles fat, and some very interesting work has come from France about that. What they have discovered is that when animals on a very high-fat diet--the typical American problem--were given a diet low in magnesium, they had a very high concentration of the "bad" low-density lipids. When the researchers increased the magnesium intake of these animals, their high-density levels went up and low-density levels went down, which was protective. So it could very well be that our theories about the protective qualities of magnesium are not in conflict with the "fat theory"--it may very well be that the two march in tandem. Without adequate magnesium, the body cannot handle the fat excesses so common in the American diet.

Post: Some doctors give magnesiumto patients during open-heart surgery. How does this help their hearts?

Dr. SEelig: When an amount ofmagnesium approximating that in heart cells is added to the solution circulating through the heart being operated upon, or when magnesium is given to a patient before or after the surgery, the heart recovers better from the operative arrest and is less apt to develop postoperative arrhythmias.

Post: Do surgeons in the UnitedStates use this technique?

Dr. Seelig: It has not been widelyused in this country, but it is more commonly used in England and many other European countries.

Hypertension, Stress, and Sleep

Post: Can magnesium benefit peoplewith other cardiovascular problems, such as hypertension?

Dr. Seelig: Yes. However, this is acontroversial subject. Magnesium affects the tension of the arteries, causing them to relax. This means it can have a very direct effect on the hypertension so prevalent in the United States and other parts of the Western world. In particular, magnesium in experimental animals has been found to cause a relaxation of the arterial wall. However, calcium--which causes arterial constriction in experimental animals--is being recommended for hypertensives whose calcium intakes are low. Which patients respond better to calcium and which do better with magnesium is being studied by Drs. Lawrence Resnick and John Laragh of New York Hospital-Cornell Medical Center.

Post: Stress is often a problem forpeople with cardiovascular diseases. Does magnesium affect stress?

Dr. Seelig: Magnesium does improvetolerance of stress, which can cause hypertension or arrhythmias.

Post: Does that include stress fromphysical exertion?

Dr. Seelig: Yes. In fact, when peoplewith cardiovascular problems and low magnesium intake try to improve their health with strenuous exercise, such as jogging, they could be endangering their health. Magnesium requirements are markedly increased during physical stress. The heart is much more susceptible to arrhythmias during physical exertion if the magnesium level is now.

Post: Could that have been whathappened to Pheidippides, thought to be the first marathoner?

Dr. Seelig: Well, we'll never knowfor sure, but it has happened to other athletes during physical stress. Autopsy examinations of their hearts have disclosed excessive amounts of stress hormone and low levels of magnesium. Stress--whether physical or emotional--causes the adrenal glands and even the heart to produce adrenalin, a stress hormone. In the heart, this allows more calcium to enter, which is necessary to increase the strength of the heartbeat. Unfortunately, when there isn't enough magnesium available, this can increase the risk of arrhythmia.

But preventing a heart attack isn'tthe only reason athletes should make sure they have enough magnesium. Research with marathon runners and skiers has found that their muscle cramps were reduced in severity and frequency when magnesium was given during their training. Their endurance and race performance improved also. In fact, American researchers tried to do a double-blind study on this, but when the men getting the magnesium had greater endurance and fewer muscle cramps than the control group, the subjects gossiped among themselves, and finally the control group demanded the magnesium as well.

Post: Do you think athletes whotake magnesium regularly have an advantage over athletes who don't?

Dr. Seelig: I can tell you an ironicstory about that. When I was presenting an exhibit at the Third International Symposium on Magnesium in Baden-Baden, West Germany, several young physicians from western European countries came up to me and asked questions about studies they might want to set up with their own athletes. I commented that there was a rumor going around that perhaps one of the reasons some of the iron curtain countries do so well in the Olympics was that they were giving their athletes magnesium during training. I didn't notice a person standing behind me until I heard this voice saying, "It's not a rumor--it is true." I turned around, and there was this physician from East Germany who said, "We always use magnesium supplementation while we train our athletes."

He then looked troubled and said,"I hope I haven't said anything I shouldn't have--but this is all in the literature anyway." As a matter of fact, some of the most important data on the efficacy of magnesium increasing the performance of athletes come from Rumania. We can wonder to what extent they use magnesium and, if our own Olympic athletes were given magnesium, would they do even bettern than they do now.

Post: If magnesium reducesstress, does it help the body relax? Could it be a natural tranquilizer for people who have trouble sleeping?

Dr. Seelig: That's a verydifficult question for me to answer. We know that increasing magnesium is extremely important in decreasing irritability and tension in people with low levels of magnesium. Such people, who tend to be anxious, should sleep better when their magnesium inadequancies are corrected. Magnesium-deficient rats have slept better when their magnesium is increased. I haven't seen studies on the effect of magnesium on insomniacs, but I have spoken with physicians who said their patients seem to do better. That's not scientific, however.


Post: Short of moving to NorthDakota, how can we make sure we get enough magnesium in our diet? What foods are high in magnesium?

Dr. Seelig: Shellfish are the proteinfoods probably highest in magnesium. Interestingly enough, salmon is extremely high in magnesium, and we're all familiar with the use of omega-o fatty acids from salmon, which have been found to be useful in cardiovascular disease. I wonder whether those who eat large amounts of fish are also being helped by the magnesium.

Dark green vegetables, such asspinach, are rich in magnesium, as are beans, nuts, and chocolate. Whole grains are much better than refined grains for magnesium. On the other hand, high-fiber foods and supplements might interfere with absorption of some minerals, including zinc and magnesium. People eating a very high-fiber diet might want to look into the possibility that the fiber is interfering with magnesium absorption, even though their diets are likely to be rich in magnesium.

In the Harvard Medical School,Drs. Edward Kass and Frank Sacks are currently investigating why vegetarians tend to have lower blood pressure and lower incidence of cardiovascular disease--and a generally longer life expectancy--than individuals on high-fat diets with a lot of meat. They are looking at several potentially protective minerals in a vegetarian diet, including potassium, calcium, and magnesium. Vegetarians tend to have a much higher level of magnesium.

Post: So once again we see evidencethat shifting our diets away from red meats and high fat toward vegetables and seafood could lengthen our lives.

Dr. Seelig: Yes. However, I havefound from experience that it is very difficult to get people to change their dietary habits, particularly when you take into account that even social drinking causes substantial loss of magnesium. A cocktail before dinner and wine with dinner will wash out a fair amount of magnesium, even in a vegetarian meal. Alcohol is a major factor in causing magnesium deficiency. So what is a little more practical is to provide magnesium supplements.

We all tend to think that magnesiumin no matter what form is all right. Even milk of magnesia, which is a laxative, is converted into magnesium chloride in the stomach if the stomach acidity is normal. There is also a magnesium-chloride product available that's slow-released and enteric. I haven't seen the data on this, but I understand this form has been better tolerated than the milk of magnesia preparations, which if taken in large quantities have the classic effect. Runners given milk of magnesia may have to run--and not just to win the race.

Post: Do you take magnesium supplements?

Dr. Seelig: Yes, I've taken magnesiumfor almost 20 years. I usually take at least 200 mg a day because I come from a family with a history of hypertension. Many factors contribute to high blood pressure, and it is not surprising that my taking magnesium for many years has not prevented development of hypertension, for which I take an antihypertensive drug. Whether the magnesium prevented as severe a form of the disease as afflicted my father, who had multiple small strokes when he was much younger than I am now, I can only speculate.

To learn whether an increasein magnesium intake will prevent some of the cardiovascular diseases that plague our society will take extensive controlled studies.

Post: Many of our readersalready take calcium supplements. How does magnesium interact with calcium?

Dr. Seelig: There is a greatdeal of interest now and a great deal of information on television concerning the importance of calcium in preventing or treating osteoporosis. What is not generally considered, though, is that calcium and magnesium are competitive. Calcium is important to increase the mineralization of the bone. However, unless the organic portion of the bone--the matrix--is kept healthy, increasing mineralization can cause the bone to become marble-like and to lose elasticity. Magnesium is necessary for healthy bone matrix, and one way estrogen, the normla anti-osteoporatic substance, maintains the bone matrix is by increasing the deposition of magnesium. Since estrogen increases the shift of magnesium to bone and both work to decrease the risk of fracture by maintaining bone elasticity, it could be that postmenopausal women on estrogen should increase their magnesium intake as part of their osteoporosis-Prevention program.

Other Conditions

Post: Do premenopausal womenneed as much magnesium as men?

Dr. Seelig: Apparently women canmanage better with less than men, at least before menopause. Men do not retain or utilize magnesium as well as do young women, and men often need more because of their greater physical activity. But the current level still isn't an optimal quantity for women, especially when they're pregnant or nursing. Recent work shows that even the typical middle-class white women doesn't get the optimal amount of magnesium to maintain a normal pregnancy and at the same time build up the fetus.

Now, this has very serious implicationsin terms of the health and maintenance of the heart and arteries. For young pregnant women, especially growing teen-age mothers, it can mean that they are more vulnerable to hypertension and other manifestations of preeclampsia. Interestingly enough, although magnesium was used in the treatment of eclampsia--a malignant form of hypertension usually accompanied by convulsions--probably since the turn of the century, it was always used as a drug; very rarely did physicians consider the possibility that perhaps when they administered the magnesium, they were providing something the pregnant women weren't getting enough of.

Post: If magnesium has so manybenefits, why don't more doctors recommend it to their patients?

Dr. Seelig: Physicians quite rightlydo not want to use something they cannot ascertain the effects of or to which they cannot clearly attribute specific effects. This has been a problem with magnesium, because until recently magnesium levels were very difficult to measure accurately in the body. the usual procedure is to measure the serum level. Unfortunately, serum determinations are not very valuable unless the individual has a very low magnesium level or a very high level, either of which can indicate magnesium deficiency--from dietary inadequacies, alcohol intake, disease, or treatment with drugs that increase the kidney's excretion of magnesium. High serum levels of magnesium can reflect kidney disease that prevents normal elimination of large quantities of magnesium.

More recently, there has been interestin measuring magnesium in tissues or in measuring the percentage of retention of magnesium in people with normal kidneys by giving them a slow intravenous drip or intramuscular injection of magnesium. In this way the body cannot avoid getting a large amount of magnesium, and you can ascertain how much is retained. If the individual retains more than 30 percent, there is evidence he is probably low in magnesium to start with.

Because measurement of magnesiumwas difficult until fairly recently, few medical schools provided much information on this essential mineral. I hate to say it, but relatively little information on nutrition is given in medical schools at the present time. Although our physicians in the United States are aware of magnesium, I hope they will become more so as methodology improves.

One physician who is certainlyaware of what magnesium has to fofer is Dr. Charles B. Seelig, Mildred Seelig's son, an internist at the University of Nebraska Medical Center. For the Seeligs, magnesium research is a family affair, as might be expected: "I've been hearing about magnesium since I was ten years old," Charles said.

The younger Dr. Seelig is currentlyconducting a clinical study on the retention of magnesium in patients who are on diuretics, a group of drugs used to treat hypertension. Preliminary results confirm the conclusions of other studies: diuretics can cause a depletion of magnesium and potassium. But diuretics have been proven very effective in treating hypertension, which raises a troubling paradox: how can a drug that depletes magnesium be so effective in treating a condition also helped by supplemental magnesium? "Obviously, there are multiple factors involved," Dr. Charles Seelig said. "Just looking at magnesium alone isn't going to be the answer for every individual." The next stage of his research will investigate whether the magnesium levels of patients on diuretics can be maintained by magnesium supplementation.

Does this practicing physician recommendmagnesium to his patients? "Generally I do," he said, "but only if they ask about supplements that might be helpful, or if they have a specific medical problem I think magnesium could significantly help. For instance, I think anyone who has a family history of heart disease probably should take magnesium supplements."

Another project from the Seeligfamily could bring their vast knowledge of magnesium's benefits right into our own homes. The two doctors plan to rewrite Mildred Seelig's magnesium text, a technical volume intended for physicians and researchers, into a book more readily understandable to those of us not as familiar with biochemistry and physiology. If ongoing research continues to confirm the Seeligs' beliefs about the importance of magnesium, we wouwould all be wise to have such a book on our shelves.
COPYRIGHT 1987 Saturday Evening Post Society
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Copyright 1987 Gale, Cengage Learning. All rights reserved.

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Author:Grindy, Robert
Publication:Saturday Evening Post
Article Type:interview
Date:Jul 1, 1987
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